16 research outputs found
Tramadol vs dexmedetomidine for emergence agitation control in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia: prospective randomized controlled clinical study
Tramadol vs dexmedetomidine for emergence agitation control in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia: prospective randomized controlled clinical study.
This study was designed to compare the efficacy of an intraoperative single dose administration of tramadol and dexmedetomidine on hemodynamics and postoperative recovery profile including pain, sedation, emerge reactions in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia
Comparison of the effects of fentanyl and remifentanil on splanchnic tissue perfusion during cardiac surgery.
The purpose of this study was to compare the effects of fentanyl and remifentanil on splanchnic perfusion during coronary artery bypass graft (CABG) surgery. Fifty patients were randomized to receive either fentanyl (10 mu g.kg(-1) at induction and 5 mu g.kg(-1).h(-1) infusion for maintenance) or remifentanil (3 mu g.kg(-1) at induction and 1 mu g.kg(-1).min(-1) infusion for maintenance). Patients in both groups were comparable with regard to demographics. Intraoperative volume management and inotropic therapy were similiar in both groups. Regarding heart rate, there were no significant differences between the groups at any measurement time (P > 0.05). Compared to the fentanyl group, the remifentanil group showed a significant decrease in mean arterial pressure during induction. Also, the gastric intramucosal CO, pressure (Pg(CO2)) and the Pg(CO2) gap, defined as the difference between Pg(CO2) and Pg(CO2) were significantly increased and the gastric mucosal pH (pHi) was significantly decreased in the remifentanil group in the postinduction period (P 0.05). Both fentanyl and remifentanil seemed to be effective and well tolerated in this CABG population. Episodes of hypotension and transient reduction in splanchnic perfusion were more common in patients treated with remifentanil when compared to those receiving the fentanyl opioid regimen
Tramadol vs dexmedetomidine for emergence agitation control in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia: prospective randomized controlled clinical study
Background: This study was designed to compare the efficacy of an
intraoperative single dose administration of tramadol and
dexmedetomidine on hemodynamics and postoperative recovery profile
including pain, sedation, emerge reactions in pediatric patients
undergoing adenotonsillectomy with sevoflurane anesthesia.
Methods: Seventy-seven patient, aged 2-12, undergoing adenotonsillectomy
with sevoflurane anesthesia was enrolled in this study. Patients were
randomly assigned to receive either intravenous 2 mg/kg tramadol (Group
T; n = 39) or 1 mu g/kg dexmedetomidine (Group D; n = 38) after
intubation. Heart rates (HR), mean arterial pressure (MAP) were recorded
before induction, at induction and every 5 min after induction.
Observational pain scores (OPS), pediatric anesthesia emergence delirium
(PAED) scores, percentage of patients with OPS = 4 or PAED scale items 4
or 5 with an intensity of 3 or 4, and Ramsay sedation scores (RSS) were
recorded on arrival to the postoperative care unit (PACU) and at 5, 10,
15, 30, 45, 60 min. Extubation time and time to reach Alderete score > 9
were recorded.
Results: Dexmedetomidine significantly decreased the HR and MAP 10 and
15 min after induction; increased the RSS 15, 30 and 45 min after
arrival to PACU. OPS and PAED scores and percentage of patients with OPS
= 4 or PAED scale items 4 or 5 with an intensity of 3 or 4 in both
groups did not show any significant difference. Extubation time and time
to have Alderete score > 9 was significantly longer in Group D.
Conclusion: Both tramadol and dexmedetomidine were effective for
controlling pain and emergence agitation. When compared with tramadol
intraoperative hypotension, bradycardia and prolonged sedation were
problems related with dexmedetomidine administration
Suspected Central Anticholinergic Syndrome Related to Cycloplegic Eye Drop in a Premature Baby
The therapeutic approach for the central anticholinergic syndrome after application of cycloplegic eye drops in a premature infant patient who was scheduled for laser photocoagulation under general anesthesia is reviewed in the light of the relevant literature
Radiographic comparison of cervical spine motion using LMA Fastrach, LMA CTrach, and the Macintosh laryngoscope
Background/aim: The optimal technique for airway management in patients
with cervical pathology remains unclear. Intubating laryngeal mask
airway devices such as LMA CTrach and LMA Fastrach have not been
compared for cervical spine (C-spine) movements in the context of
cervical pathology The present study aimed to determine upper C-spine
movements by radiography during intubation with different devices as
well as comparing the duration and success of intubation in cervical
surgery.
Materials and methods: Sixty patients scheduled for elective cervical
surgery were registered in this prospective, randomized study. Patients
with cervical trauma/injury, previous neck surgery, and body mass index
(BMI) of >35 kg/m(2) were excluded. Participants were randomized to one
of the 3 groups: LMA CTrach, LMA Fastrach, or the Macintosh
laryngoscope. C-spine motion was evaluated by measuring angles created
by bordering vertebrae at cervical 1/2 and 2/3 (C1/2, C2/3) segments on
2 lateral cervical radiographs for each patient. Intubation time, ease
of intubation, number of attempts, and success rate were also
documented.
Results: Demographic data were similar in all the groups. The cervical
movement with LMA CTrach and LMA Fastrach compared to the Macintosh
laryngoscope were similar at C1/2. However, LMA CTrach significantly
reduced extension compared to LMA Fastrach and Macintosh laryngoscopes
at C2/3. Duration of intubation was significantly shorter with the
Macintosh laryngoscope. The rate of successful intubation was 80\% with
LMA Fastrach and 100\% with both LMA CTrach and the Macintosh
laryngoscopes.
Conclusion: The LMA CTrach laryngoscopy involves less upper C-spine
movement than the LMA Fastrach and does not increase the duration of the
intubation period
A comparison of fentanyl-propofol with a ketamine-propofol combination for sedation during endometrial biopsy
Study Objective: The purpose of this study was to compare the clinical activities of ketamine and fentanyl when used in combination with propofol for outpatients undergoing endometrial biopsy. The investigated parameters were respiration, sedation, recovery rate, side effects, time to discharge, and patient satisfaction
Hipertansif Hastalarda Entübasyona Hemodinamik Yanıt Sevofluran İndüksiyonu İle Önlenebilir Mi
Sevoflurane exerts brain-protective effects against sepsis-associated encephalopathy and memory impairment through caspase 3/9 and Bax/Bcl signaling pathway in a rat model of sepsis
Objective We compared the effects of sevoflurane and isoflurane on
systemic inflammation, sepsis-associated encephalopathy, and memory
impairment in a rat sepsis model of cecal ligation and puncture
(CLP)-induced polymicrobial peritonitis.
Methods Twenty-four rats were assigned to sham, CLP, CLP+sevoflurane,
and CLP+isoflurane groups. At 72 hours after CLP, the rats underwent
behavior tests. Serum cytokines were evaluated. Brain tissue samples
were collected for determination of glutathione peroxidase (GPX),
superoxide dismutase (SOD), and catalase; the wet/dry weight ratio;
myeloperoxidase (MPO) and malondialdehyde (MDA); apoptotic gene release;
and histologic examinations.
Results The MPO level, wet/dry weight ratio, and histopathology scores
were lower and the Bcl2a1 and Bcl2l2 expressions were upregulated in
both the CLP+sevoflurane and CLP+isoflurane groups compared with the CLP
group. The interleukin-6, interleukin-1, MDA, and caspase 3, 8, and 9
levels were lower; the GPX, SOD, Bax, Bcl2, and Bclx levels were higher;
and non-associative and aversive memory were improved in the
CLP+sevoflurane group compared with the CLP+isoflurane group.
Conclusion Sevoflurane decreased apoptosis and oxidative injury and
improved memory in this experimental rat model of CLP. Sevoflurane
sedation may protect against brain injury and memory impairment in
septic patients